In rude health and with a sharp eye to the future

Amid the gloom surrounding Australia's struggle to sell its manufactures overseas, who can name our top manufactured exports? The winning merchandise tends not just to be made in Australia, but invented here, too. The products come from a clean, smart industry. Its leading players are barely household names and there are many other smaller enterprises whose output sells around the world.

We are talking about the biomedical industry, which in recent years has risen to top place among Australia's elaborately transformed manufactured exports, leaving cars and wine far behind.

Whether it be an underarm gel to treat grumpy old men, a device to correct sleep disorders, a transforming treatment for head lice or a product to reverse dental decay, this country's biomedical inventions are earning a significant slice of the $4 billion Australia earns in exports from pharmaceutical and medical gadget exports.

This week's announcement of a significant advance towards a bionic eye follows the international success of the Melbourne-developed bionic ear, the centrepiece of the hugely successful multinational Cochlear company, now generating $1 billion in sales.

It used to be argued that Australia was strong on medical ideas - thus six Nobel prizes for medicine - but weak on taking the idea from the laboratory to the bedside. But in the past two decades, a sea change has come. Besides Cochlear there are CSL and Resmed and they all ride significantly on local expertise. CSL is the plasma and vaccine conglomerate which in recent years mass produced the cervical cancer vaccine Gardasil, created by Australian Ian Frazer and his team.

ResMed, which is now based in San Diego but was born of the pioneering design of Sydney University's Professor Colin Sullivan of a device to beat obstructive sleep apnoea, still drives much of its research and development in Australia.

But who knows that the worth of Australia's publicly listed biomedical companies is actually higher on a per capita basis than is the case for such companies in the US? Australia's higher input is despite a much lower level of venture capital investment compared with the US.

The paradox is that despite Australia's relatively golden performance, the nation appears to display scant interest in its home-grown smart performers glowing in the sophisticated arena of medical research and development.

The biotech industry blooms, while the heavily-protected car manufacturers struggle to survive and the winemakers prosper behind a defensive tax regime.

Little-known Australian companies such as Pharmaxis are scoring international approvals and sales for its medications for lung disease, and opening factories in Australia too. Its products include Bronchitol, developed in Australia and offering a new treatment for cystic fibrosis, one of the world's most common life-shortening genetic diseases.

Another rising star is Acrux, which has gained a world reputation for its products, developed by Monash University scientists. These are fast-drying sprays and liquids including an underarm testosterone treatment for men.

The small company Mesoblast describes itself as a world leader in ''regenerative medicine'' for treatments of rheumatoid arthritis. It is linking with global businesses to develop adult stem cell therapeutics for conditions including cardiovascular and central nervous system diseases.

Australia's medical research and development is the subject of a review which is expected to urge fundamental changes to ensure research is ''embedded'' into the health and hospital system and to call for more funding to match the soaring research effort overseas.

The federal government has commissioned Simon McKeon, the chairman of the CSIRO, to report later this year on findings of a wide-ranging inquiry into the strategic direction of medical research.

A recent review in NSW by Peter Wills has prompted a state overhaul to foster stronger ''translation'' of research, aimed at speeding the transfer of proven results from the laboratory to the patient care.

The Federal Health Minister, Tanya Plibersek, who ensured her portfolio included medical research when she took on the job, says she cannot get over the breadth and quality of research work she sees.

Plibersek is not signalling her likely response, but the funding of medical research, now running at $800 million a year, is the subject of intense debate.

The National Health and Medical Research Council funds a mind-numbing range of areas. The McKeon review is finding sharp criticism of the way funding gets shared around at present; that regulatory hoops keep scientists from their laboratories for weeks at a time meeting bureaucratic requirements; and that too little money is spared to finance promising discoveries in the crucial time between invention and commercial development.

In talks to other scientists, McKeon is said to have pressed for greater ''embedding'' of medical research in everyday healthcare.

The retiring chief executive of CSL, Brian McNamee, says Australia needs ''to keep nurturing our world-class research base, but we should think about how we can better help institutes take their ideas from the lab through to initial human trials''.

Strong research results, he says, can attract investment from industry ''for the most expensive and risky phases of development''.